Basha Adil, Karatas Rifat, Taneja Atul Kumar, Chhabra Avneesh, Silva Flavio Duarte
Texas A&M Health Science Center, Bryan, TX-77807, USA.
Department of Radiology, UT Southwestern Medical Center, Dallas, United States.
Skeletal Radiol. 2025 May;54(5):1159-1163. doi: 10.1007/s00256-024-04850-w. Epub 2024 Dec 10.
Antihistamines, such as diphenhydramine, are active ingredients of a wide variety of antiallergics, sedatives, and sleep preparations and are often abused for purposes of euphoric effects or suicidal attempts. Antihistaminic overdose presents with symptoms of increased anticholinergic activity including urinary retention, mydriasis, and dry mucous membranes. However, antihistamine-induced rhabdomyolysis is a rare condition that presents with widespread skeletal muscle breakdown and release of metabolites into the circulation, resulting in myalgias and acute kidney injury. In this article, we report a rare case of rhabdomyolysis following the ingestion of a large quantity of diphenhydramine for a suicide attempt, who also presented with significantly elevated creatine kinase and acute renal injury. To our knowledge, this is the first case report of diphenhydramine rhabdomyolysis with MRI findings' correlation.
抗组胺药，如苯海拉明，是多种抗过敏药、镇静剂和助眠制剂的活性成分，常被滥用以期获得欣快感或用于自杀企图。抗组胺药过量会出现抗胆碱能活性增加的症状，包括尿潴留、瞳孔散大和黏膜干燥。然而，抗组胺药引起的横纹肌溶解是一种罕见病症，表现为广泛的骨骼肌分解以及代谢产物释放到循环系统中，从而导致肌肉疼痛和急性肾损伤。在本文中，我们报告了一例罕见的因自杀企图大量服用苯海拉明后发生横纹肌溶解的病例，该患者还出现肌酸激酶显著升高和急性肾损伤。据我们所知，这是首例有MRI检查结果相关性的苯海拉明致横纹肌溶解病例报告。
